Significance of detecting oxidative stress and inflammatory response in the treatment of vascular crisis after finger replantation

Objective: To explore the significance of detecting oxidative stress and inflammatory response in the treatment of vascular crisis after finger replantation. Methods: The data of 86 patients with replantation of severed finger were collected. According to whether vascular crisis occurred after the surgery, the patients were divided into crisis group and non-crisis group to analyze the risk factors of vascular crisis. Moreover, all patients with vascular crisis were divided into conservative treatment group (patients cured by conservative treatment) and secondary surgery group (patients treated by surgery again after the failure of conservative treatment). Blood samples of patients from two groups were collected and the changes of serum inflammatory cytokines and markers of oxidative stress response were compared between the two groups when they were admitted to hospital and when vascular crisis occurred. Results: Gender, age, smoking history, ischemic time, cause of injury, plane of division, complete or incomplete severance were related risk factors for vascular crisis after finger replantation. The nitric oxide (NO), malondialdehyde (MDA) and superoxide dismutase (SOD) levels as well as serum inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) contents of patients in the secondary surgery group were higher than that of patients in the conservative treatment group (all P<0.05). Conclusion: The occurrence of vascular crisis is a key factor in the failure of finger replantation. The levels of NO, MDA, SOD, IL-6 and TNF-alpha can be used as important indicators to evaluate the vascular crisis after replantation of severed finger, and can also be used as potential targets for the treatment of vascular crisis after finger replantation, which has great clinical application value.